Short-Term Versus Long-Term Antibiotic Prophylaxis for Elective Cesarean Section Deliveries, Prospective Comparative Study
Keywords:
Cesarean section; Antibiotic prophylaxis; Postoperative infection.Abstract
Background: An increased risk of postpartum infectious problems is linked to Cesarean section's deliveries. Prolonged post-surgical antibiotic courses are often used despite data suggesting shorter regimens. In this trial, short term and long-term antibiotic prophylaxis were compared in low-risk women undergoing elective Cesarean sections deliveries.
Methods: From January to June, two hundred and forty low risk term pregnant women underwent elective Cesarean section at Minya El-Qamh Central Hospital and Zagazig University Hospitals were included in this prospective comparative study with systematic allocation. Participants were allocated into two equal groups according to odd/even sequence numbers. Group A, n=120 (short-term) received two intravenous doses of cefotaxime 1 gm, 12 hours a part, whereas Group B, n=120 (long-term) received the same as group A followed by cefotaxime twice daily for another two days followed by oral cefixime (400 mg, once /day) for another three days. Patients were followed for the next six weeks for postoperative infectious morbidity.
Results: No statistically significant differences in measured postoperative morbidities were detected. Postpartum fever occurred in 10.0% of Group A (short-term antibiotic prophylaxis) versus 7.5% of Group B (long-term antibiotic prophylaxis) (P = 0.49), endometritis diagnosed in 0.8% versus 1.7% (P = 0.99), respectively. Superficial wound infection affected 2.5% versus 1.7%, deep wound infection affected 0.8% in each group, urinary tract infections (UTI) diagnosed in 5.8% versus 3.3% (P = 0.54), and hospital stay was similar (17.8 ± 3.2 versus 18.1 ± 3.4 hours; P = 0.482) in both groups.
Conclusion: short-term antibiotic prophylaxis was not associated with a statistically significant increase in measured postoperative infectious morbidities compared to prolonged antibiotic prophylaxis perioperative and post-operative elective Cesarean section deliveries, that support reduced antibiotic exposure especially in low resources countries like Egypt.